John Esimaje Moyegbone¹*, Ezekiel Uba Nwose^2,3, Charles Chukwuemeka Ofili², Eghonghon Ehianata Onoikhua¹, Emmanuel Agbonomhen Agege², Joseph Onyedenyifa Odoko², Omatseye Alero Akuirene² and Favour Alero Fregene²

¹Department of Optometry, Bingham University, Karu, Nasarawa State, Nigeria
²Department of Public and Community Health, Novena University, Ogume, Delta State, Nigeria
³School of Health and Medical Sciences, University of Southern Queensland, Toowoomba, Australia

*Corresponding Author: John Esimaje Moyegbone, Department of Optometry, Bingham University, Karu, Nasarawa State, Nigeria.

Received: July 24, 2023; Published: July 28, 2023

Abstract

The eyes like every other organ of the body, are biochemical elements that respond to both helpful or harmful biochemical stimuli leading to either a healthy or pathological state. Anaemia, antioxidant vitamin deficiencies and visual impairment (VI) are public health problems resulting in poor eye health globally. This study aimed to determine the relationship among anaemia, antioxidant vitamins and VI as well as the effect of antioxidant vitamins and iron supplements on visual acuity and anaemia. A pretest-posttest study of 201 respondents randomly selected from primary and secondary schools in three senatorial districts of Delta State, Nigeria. Sociodemographic data and visual acuity tests were done before and after intervention. Preventive intervention with a single dose of vitamin A, daily Vitamin C, weekly vitamin E, and twice weekly ferrous sulphate supplements was administered for five weeks. Spectacle prescriptions were administered to correct refractive errors (RE). Pretest-posttest haemoglobin and serum vitamins ACE were done using JENWAY 6320D Spectrophotometer. Data were analysed using SPSS version 28.0. Statistical significance was defined as P< 0.05. Findings showed that 83 (41.3%) were males and 118 (58.7%) were females with a mean age of 12.30± 3.14 years. Prevalence of anaemia and VI at baseline was 38.3% and 28.9% respectively, and 0% and 5.5% post-intervention respectively. Prevalence of vitamins A and C at baseline was 12.4% and 12.9% respectively, and post-intervention was 6.0% and 15.9% respectively. Prevalence of vitamin E at baseline and post-intervention was 0.0% respectively. RE was the major cause of VI with a prevalence of 23.4%. The association between visual impairment at baseline and impaired vision with spectacle prescription intervention was statistically significant (P=0.001). The correlation of anaemia, vitamins ACE and VI were not statistically significant (P>0.05). Odd ratios of vitamins ACE and iron supplements were predicted to decrease the risk of having anaemia and VI, though not statistically significant (P>0.05). This study showed that antioxidant vitamins and iron supplementation as well as spectacle prescription were effective in reducing the prevalence of anaemia, antioxidant vitamin deficiencies and visual impairment among primary and secondary school children in Delta State.

 Keywords: Anaemia; Antioxidant Vitamins; Deficiency; Haemoglobin; Visual Impairment; Refractive Error

References

1. Hung NV., et al. “Anemia, Malaria and Hookworm Asian, Infections in a Vietnamese Ethnic Minority”. Southeast Asian Journal of Tropical Medicine and Public Health 36 (2005): 816-821.
2. Nelima D. “Prevalence and Determinants of Anaemia among Adolescent Girls in Secondary Schools in Yala Division Siaya District, Kenya”. Universal Journal of Food and Nutrition Science 3 (2015): 1-9.
3. World Health Organization/UNICEF. Iron deficiency anaemia, assessment, prevention and control: a guide for programme managers. World Heal. Organ. Geneva. (2001).
4. Moyegbone JE., et al. “Epidemiology of visual impairment: focus on Delta State, Nigeria”. The International Journal of Community Medicine and Public Health 7 (2020): 4171-4179.
5. Ifebajo A., et al. “Assessment of Anthropometric and Iron Status of School Children in Somolu Local Government Area of Lagos State, Nigeria”. International Journal of Advanced Academic Research 6 (2020): 60-82.
6. Dreyfuss E., et al. “Hookworms, Malaria and Vitamin A Deficiency Contribute to Anemia And Iron Deficiency among Pregnant Women in the Plains Of Nepal”. Journal of Nutrition 130 (2000): 2527-2536.
7. Mikki N and H Stigum. “Anaemia prevalence and associated sociodemographic and dietary factors among Palestinian adolescents in the West Bank”. Eastern Mediterranean Health 17 (2011): 208-217.
8. Moyegbone J., et al. “Preventive programs in public health : seminar presentations on HIV, malaria and visual impairment”. International Journal of Advances in Medicine 9 (2022): 856-859.
9. Wirth JP., et al., Vitamin A Supplementation Programs and Country-Level Evidence of Vitamin A Deficiency”. Nutrients 9 (2017): 190-107.
10. Ross DA. “Recommendations for Vitamin A Supplementation”. Journal of Nutrition 131 (2002): 2902S-2906S.
11. Maziya-Dixon BB., et al. “Vitamin A deficiency is prevalent in children less than 5 y of age in Nigeria”. Journal of Nutrition 136 (2006): 2255-2261.
12. Hayder MA-T., et al. “Association between Low Serum Vitamin C Level and Cataract in Elderly Patients”. EC Ophthalmology 10 (2019): 751-760.
13. Kamath YS., et al. “The association of age-related cataract and serum Vitamin C”. Indian Journal of Clinical and Experimental Ophthalmology 4 (2017): 287-290.
14. Rowe S and AC Carr. “Factors Affecting Vitamin C Status and Prevalence of Deficiency : A Global Health Perspective”. Nutrients 1 (2020): 1-19.
15. Chen H., et al. “Role of serum vitamin A and E in pregnancy”. Experimental and Therapeutic Medicine 16 (2018): 5185-5189.
16. Morris M., et al. “Vitamin E and cognitive decline in older persons”. Archives of Neurology 59 (2002): 1125-1132.
17. Odoko J., et al. “Factors Influencing Utilization of Insecticide-treated Nets among Pregnant Women and Children in Bayelsa and Rivers States, Nigeria”. International Journal of Tropical Diseases 44 (2023): 55-69.
18. Alghadir AH., et al. “Association of physical activity, vitamin E levels, and total antioxidant capacity with academic performance and executive functions of adolescents”. BMC Pediatrics 19 (2019): 156-163.
19. Eiler RJ. “Cyanmethemoglobin”. American Journal of Clinical Pathology 47 (1967): 212.
20. Henry RF., et al. “Principles and Techniques in Clinical Chemistry”. 2^nd, MD, Hagerstown, (1974).
21. Chan M. “Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity”. Geneva, Switz. World Heal. Organ. (2011): 1-6.
22. Neeld WN and JB Jr Pearson. “Macro and micro methods for the determination of serum vitamin A using trifluoroacetic acid”. Journal of Nutrition 79 (1963): 454-462.
23. Mejia L and G Arroyave. “The effect of vitamin A fortification of sugar on iron metabolism in preschool children in Guatemala”. American Journal of Clinical Nutrition 36 (1982): 87-93.
24. World Health Organization., et al. “Vitamin A supplements : a guide to their use in the treatment of vitamin A deficiency and xerophthalmia / prepared by a WHO/UNICEF/IVACG task force”. 2^nd, World Heal. Organ. (1997).
25. Sadasivam A and S Manickam. “Biochemical methods”. 3^rd, New Age International Publishers, New Delhi, India, (2008).
26. Kivcak T and B Mert. “Quantitative determination of a-tocopherol in Arbutus Ledo densitometry and Colorimetry”. Fitotetrapia 72 (2001): 656-661.
27. Bates B., et al. “National Diet and Nutrition Survey Years 1 to 9 of the Rolling Programme (2008/2009-2016/2017): Time Trend and Income Analyses”. Public Heal. Engl. London, UK. (2019): 56.
28. Traber M and D Manor. “Vitamin E”. Advances in Nutrition 3 (2012): 330-331.
29. Ramke J., et al. “Prevalence and causes of blindness and low vision in Timor‐Leste”. British Journal of Ophthalmology 91 (2007): 1117-1121.
30. Moyegbone J., et al. “Prevalence of Visual Impairment among Primary and Secondary School Children in Delta State, Nigeria”. Journal of the Nigerian Optometric Association 25 (2023): 42-53.
31. World Health Organization. “Guideline: Vitamin A supplementation in infants and children 6-59 Months of Age”. Geneva World Heal. Organ. (2011).
32. Stoltzfus R and M Dreyfuss. “Guidelines for the use of iron supplements to prevent and treat iron deficiency anemia”. ILSI Press, Washington DC, 1998.
33. Tanumihardjo S. “Biomarkers of vitamin A status: what do they mean?”, in: World Heal. Organ. Rep. Priorities Assess. Vitam. A Iron Status Popul., Geneva, World Health Organization., Panama City, Panama, 15-17 September 2010, (2012).
34. Assefa S., et al. “Prevalence and severity of anemia among school children in Jimma Town, Southwest Ethiopia”. BMC Hematology 14 (2014): 1-9.
35. Akeredolu IA., et al. “Iron, Zinc, and Copper Malnutrition among Primary School Children in Lagos, Niagara”. Food and Nutrition Sciences 02 (2011): 1063-1070.
36. Low M., et al. “Effects of daily iron supplementation in primary-school- aged children: systematic review and meta-analysis of randomized controlled trials”. Cmaj 185 (2013): 1477-1478.
37. Salim S., et al. “Prevalence and Factors Associated with Iron Deficiency Anemia among School-Age Children in Primary Schools in Burao City, Somaliland, 2020”. Journal of Blood Disease 11 (2021): 67-80.
38. Getaneh Z., et al. “Prevalence of Anemia and Associated Factors among School Children in Gondar Town Public Primary Schools, Northwest Ethiopia: A School-Based Cross-Sectional Study”. PLoS One 12 (2017): E0190151.
39. Andriastuti M., et al. “Prevalence of Anemia and Iron Profile among Children and Adolescents with Low Socio-Economic Status”. International Journal of Pediatrics and Adolescent Medicine 7 (2020): 88-92.
40. Nkurunziza J., et al. “Prevalence and factors associated with anaemia in children aged 6 - 24 months living a high malaria transmission setting in Burundi”. PLoS One 17 (2022): e0273651.
41. Jalambo M., et al. “Prevalence of Anemia , Stunting and Parasitic Infection Among 5-6 Years Prevalence of Anemia, Stunting and Parasitic Infection Among 5-6 Years Children in Gaza Strip, Palestine, Public Heal”. Preventive Medicine 5 (2020): 5-15.
42. Eltayeb MS., et al. “Assayed, Prevalence of Anaemia among Quranic School (Khalawi): Students (Heiran): in Wad El Magboul Village, Rural Rufaa, Gezira State, Central Sudan: A Cross-Sectional Study”. Pan African Medical Journal (2016): 24.
43. Atimati A., et al. “High prevalence of vitamin A deficiency in school-age children in Benin City”. Annals of Biomedical Sciences 11 (2012): 106-116.
44. Ayogu RNB., et al. “Prevalence and factors associated with anthropometric failure, vitamin A and iron deficiency among adolescents in a Nigerian urban community”. African Health Sciences 16 (2016): 389-398.
45. McCall S., et al. “Plasma vitamin C levels: Risk factors for deficiency and association with self-reported functional health in the European Prospective Investigation into Cancer-Norfolk”. Nutrients 11 (2019): 1552.
46. Rizvi S., et al. “The Role of Vitamin E in Human Health and Some Diseases”. SQU Medical Journal 14 (2014): 157-165.
47. Vashist P., et al. “Blindness and visual impairment and their causes in India: Results of a nationally representative survey”. PLoS One 17 (2022): e0271736.
48. Alabi A., et al. “Visual Impairment and Ocular Morbidities among Schoolchildren in Southwest, Nigeria”. Nigerian Postgraduate Medical Journal 25 (2018): 166-171.
49. Zelalem M., et al. “Prevalence of visual impairment among school children in three primary schools of Sekela Woreda, Amhara regional state”. SAGE Open Medicine 7 (2019): 1-8.
50. Seid M., et al. “Visual impairment and its predictors among people living with type 2 diabetes mellitus at Dessie town hospitals , Northeast Ethiopia: institution-based cross-sectional study”. BMC Ophthalmology 22 (2022): 52-64.
51. Atlaw D., et al. “Prevalence of visual impairment due to refractive error among children and adolescents in Ethiopia: A systematic review and meta-analysis”. PLoS One 17 (2022): e0271313.
52. Nayak S., et al. “Prevalence of Anaemia and Visual Impairment among School Going Adolescents of Patan City, Gujarat: A Cross-Sectional Study”. National Journal of Community Medicine 6 (2015): 449-451.
53. Thakor N., et al. “Health status of children of primary and secondary boarding schools of Gandhinagar district”. International Journal of Medical Science and Public Health 3 (2014): 866-869.
54. Srinivasan K and G Prabhu. “A Study of The Morbidity Status of Children In Social Welfare Hostels In Tirupati Town”. Indian Journal of Community Medicine 31 (2007): 51-56.
55. Panda P., et al. “Health Status of School Children in Ludhiana city”. Indian Journal of Community Medicine 4 (2000): 150-155.
56. Hashizume M., et al. “Anaemia, iron deficiency and vitamin A status among school-aged children in rural Kazakhstan”. Public Health Nutrition 8 (2005): 564-571.
57. Zhao Y., et al. “Vitamins and Mineral Supplements for Retinitis Pigmentosa”. Hindawi Journal of Ophthalmology 2019 (2019): 1-11.
58. Klaver C and A Thiadens. “Vitamin A for children with retinitis pigmentosa: an unresolved mystery”. JAMA Ophthalmology 136 (2018): 496-497.
59. Francisco SG., et al. “Dietary Patterns, Carbohydrates, and Age-Related Eye Diseases”. Nutrients 12 (2020): 1-19.

Citation

Citation: John Esimaje Moyegbone., et al. “Effects of Antioxidant Vitamins ACE and Iron Supplements on Visual Impairment among Primary and Secondary School Children in Delta State, Nigeria".Acta Scientific Ophthalmology 6.8 (2023): 30-41.

Copyright

Copyright: © 2023 John Esimaje Moyegbone., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.